Advanced Practice Nursing : Essentials for Role Development

Advanced Practice Nursing : Essentials for Role Development

  • ただいまウェブストアではご注文を受け付けておりません。 ⇒古書を探す
  • 製本 Paperback:紙装版/ペーパーバック版/ページ数 681 p.
  • 言語 ENG
  • 商品コード 9780803611191
  • DDC分類 610.73092

Table of Contents

UNIT 1 THE EVOLUTION OF ADVACED PRACTICE
1 ADVANCED PRACTICE NURSING: DOING WHAT HAD
TO BE DONE-RADICALS, RENEGADES, AND REBELS
Lynne M. Dunphy, Ellis Quinn Youngkin, 3 (28)
and Nancy K. Smith
The authors chronicle the history of
advanced practice specialties from
their earliest days, showing the
similarities and differences in their
development, the strategic governmental
and professional policy choices that
enabled survival and growth, and the
decisions that gave birth to the title
of advanced practice nurse (APN).
2 EMERGING ROLES OF THE ADVANCED PRACTICE
NURSE
Anne Keane and Deborah Becker 31 (27)
Attention is directed toward the
circumstances that have moved the APN
role into new and creative models.
Examples include the acute care nurse
practitioner, the psychiatric nurse
practitioner, the blended clinical
nurse specialist/nurse practitioner,
and the clinical specialist in
community health nursing. Several
exemplars are provided.
3 ROLE DEVELOPMENT: A THEORETICAL
PERSPECTIVE
Lucille A. Joel 58 (15)
There is only a role for the moment,
not any role that will serve for the
entire life of a career. Role
modifications are dependent on a
theoretical body of knowledge, more of
it hypothetical than empirical
research. These concepts and
relationships will allow a comfortable
paradigm shift as necessary, with an
awareness of the elements of continuity
from here to there. This chapter
includes a theoretical perspective on
the processes of knowledge and skill
acquisition, and socialization. Also
addressed are the consequent stresses
and strains that challenge most role
occupants, including how to cope with
them
4 GLOBAL PERSPECTIVE ON ADVANCED PRACTICE
Madrean Schober 73 (26)
Nurses with advanced knowledge and
skills, including prescribing, are
present in numerous countries. Country
context, the complexity of health care
services, and the structure of the
health care system all influence the
promotion and support for advanced
practice nursing globally. Descriptive
information, examples, and models of
international development are provided.
UNIT 2 THE PRACTICE ENVIRONMENT
5 PAYMENT FOR ADVANCED PRACTICE NURSING
SERVICES: PAST, PRESENT, AND FUTURE
Karen R. Robinson 99 (23)
Even as we quickly move into a
capitated system, reimbursement remains
a major issue for all APNs. Today's
health care spending is scrutinized so
closely that no APN reimbursement
opportunity can be left "untapped".
This chapter will assist APNs to
understand the reimbursement process,
identify existing reimbursement
roadblocks, and finally, strategize to
improve reimbursement efforts.
6 ADVANCED PRACTICE NURSES AND PRESCRIPTIVE
AUTHORITY
Jan Towers 122(14)
Over 90% of the American public seeking
medical attention receives a
prescription for medicine at the
conclusion of an encounter in the
health care system. While practice
patterns of APNs differ, the authority
to prescribe is critical to all.
Significant gains have been made over
the past several years. The progress
has been gradual and methodical, from
supervised practice to plenary
authority.
7 CREDENTIALING AND CLINICAL PRIVILEGES AND
THE ADVANCED PRACTICE NURSE
Ann H. Cary and Mary C. Smolenski 136(17)
Is the advanced practice legal
credential a second license, or deemed
status for the profession's
certification, or some hybrid of both?
To what degree does credentialing
guarantee competency? Should title
protection be inextricably bound to
licensure? And what about clinical
privileges? Privileging may allow
admitting, treatment, consultation, and
visiting rights. We have been slowest
to see admitting privileges for nurses,
except in rural areas. This is despite
the fact that JCAHO and Medicare
regulations permit us to hold this
status. The authors describe what is,
what could be, and how to get there
from here.
8 PARTICIPATION IN MANAGED CARE
Rita Munley Gallagher 153(18)
APNs are notably absent from managed
care provider panels. Is this due to
their predominant employee status? Are
they hesitant to mobilize consumer
support on their own behalf, or
reticent to take on the full
responsibility of a primary care
provider?
9 MALPRACTICE INSURANCE
Marie C. Infante and Sharon E. Muran 171(29)
On the surface, APN malpractice
premiums appear low. Is this a
reflection of public trust and quality
practice? On the contrary, review of
societal expectations, practice
standards, state and federal
governmental regulations, and
escalating litigation indicate
financial and professional risks for
APNs have increased substantially. APNs
can meet these challenges through an
ounce of prevention in the form of
adoption and integration of
professional practices and
risk-reduction strategies.
10 RESOURCE MANAGEMENT
Christina M. Graf 200(27)
APNs function within organizations
that, whether large or small, must
generate a profit in order to continue
to provide services and realize their
missions. Effective, quality clinical
care that also incorporates efficient
resource management is the most
desirable outcome for the patient, for
the clinician, for the organization and
for society. APNs need a clear
understanding of issues and approaches
related to resource management in order
to influence organizational
deliberations and ensure that clinical
considerations are incorporated into
fiscal and business decisions.
11 REPORTING RELATIONSHIPS: FOLLOW THE MONEY
Mary Lou S. Etheredge 227(18)
There is wide variation of opinion
regarding the reporting arrangements
preferred by APNs. In fact, there may
not be any one arrangement that the
majority would agree upon. Despite the
differences, there are common themes
that emerge. This chapter explores
these themes as they are described by
APNs in practice.
12 CONFLICT RESOLUTION IN PRACTICE: AN
ESSENTIAL ADVANCED PRACTICE NURSE COMPETENCY
Phyllis Beck Kritek 245(12)
In interpersonal relationships,
conflict is a constant, and as an
official or symbolic leader, the APN is
expected to respond. This chapter
explores that reality and its
implications for the nurse facing the
challenges of advanced practice. It
also posits that expanding conflict
resolution competency is an opportunity
to improve our work environments, and a
choice worth making.
UNIT 3 COMPETENCY N ADVANCED PRACTICE
13 EVIDENCE-BASED PRACTICE
Deborah C. Messecar and Christine A. 257(23)
Tanner
Evidence-based practice is integral to
advanced practice nursing. It builds on
the process of research utilization,
but includes much more, such as
evidence from clinical expertise, the
products of reasoning, and patient
preferences, to name a few.
14 ADVOCACY AND THE ADVANCED PRACTICE NURSE
Susan C. Reinhard, Janet Grossman, and 280(21)
Karen Piren
This chapter defines the concept of
advocacy, describing its historical
roots, while noting the limited
evidence base for its credibility.
Three advocacy exemplars are discussed
that focus on either the individual or
the larger system within which health
care and advocacy exist. The process of
preparing to be an advocate is
described along with the need for
further didactic publications and
research in this area.
15 THE KALEIDOSCOPE OF COLLABORATIVE PRACTICE
Alice F. Kuehn 301(35)
The Institute of Medicine (2001) has
called for the design of a new system
of health care delivery for the 21st
century focused upon cooperation among
professional providers as reflected by
active collaboration and communication.
Historic roots of collaborative
experiences between physician and
nurse, historic flaws in the
relationship, and factors that
influence collaborative behaviors are
described. A framework for
collaboration is presented listing
critical indicators of a highly
collaborative practice, and comparing
and contrasting examples of multi-,
inter-, and transdisciplinary practice.
Following a brief overview of role
development for each of the four APN
roles, key strategies for developing a
successful collaborative team are given.
16 CASE MANAGEMENT AND ADVANCED PRACTICE
NURSING
Patricia M. Haynor, Denise Fessier, and 336(21)
Marylou Yam
APNs and case management are almost a
natural phenomenon. Nursing case
management is a hybrid practice that
mandates a wide variety of clinical
expertise and patient management
skills. The advanced practice nurse
with additional academic knowledge and
clinical practice enhanced by
experience-based intuition can make
significant contributions towards the
coordination of multidiciplinary care.
Vignettes are presented.
17 THE ADVANCED PRACTICE NURSE AND RESEARCH
Pamela Cipriano and Suzanne Burns 357(16)
The APN is a consumer, facilitator,
collaborator, and leader in research.
The APN develops a research attitude in
others, and fosters evidence-based
practice through the integration of
research findings into clinical
practice. The APN applies the
scientific method to clinical problem
solving, and provides leadership in the
use and conduct of research. Case
studies illustrate the APN's role using
research methods to influence systems
changes, and to improve patient
outcomes through changes in clinical
practice.
18 THE ADVANCED PRACTICE NURSE AND
COMPLEMENTARY THERAPIES
Nancy Oliver 373(25)
Complementary therapies are a $32
billion a year industry for the
American public. Additionally, these
represent one area where the APN may
assist patients with integrative health
care practices. The relationship
between complementary therapies and
holistic nursing interventions provides
a valuable foundation for advanced
practice roles.
19 BASIC SKILLS FOR TEACHING AND THE ADVANCED
PRACTICE NURSE
Marilyn H. Oermann 398(32)
Teaching is an essential component of
the APN role. This chapter provides an
overview of the basic skills of
teaching: assessment of the need for
learning, strategies for assessment,
the development of objectives and a
teaching plan, teaching methods for the
APN to use in the classroom and
clinical setting, and formative and
summative evaluation. Additionally, the
qualities of effective teachers are
discussed. Examples are provided of
different teaching methods and a
teaching plan.
20 A CULTURAL VARIABLE IN PRACTICE
Mary Germain 430(25)
To fully enter the patient's experience
and provide comprehensive care that is
respectful of the patient's beliefs and
practices, you wi11 need to find ways
to bridge the linguistic and cultural
challenges that are inherent in caring
for an increasingly diverse population.
It is uncomfortable to stretch our
ethnocentric boundaries; much easier to
care for replicas of ourselves.
However, if you are open to learning
from your patients, the transient
discomfort that you experience from
having your timehonored interventions
and teaching strategies tested and
found wanting will be richly rewarded
and inform your practice for years to
come.
21 MEDIATED ROLES: WORKING THROUGH OTHER
PEOPLE
Thomas D. Smith and Maria L. Vezina 455(22)
In both direct care and mediated roles,
APNs are often dependent on the
cooperation of others to achieve their
therapeutic goals. These situations may
involve formal referral and
consultative relationships, or working
with a variety of health care
personnel, including other nurses. For
example, referral involves handing a
case over either for management by
another specialist or for co-management
among providers. Consultation implies
the process of influencing behavior
through bringing a higher order of
knowledge and experience to a
situation. The degree of authority
inherent in all of these relationships
is an important quality to assess.
Exemplars demonstrate these
relationships specific to each advanced
practice role.
UNIT 4 ETHICAL, LEGAL AND BUSINESS ACUMEN
22 EVALUATION OF THE ADVANCED PRACTICE NURSE:
COST EFFICIENCY, ACCOMPLISHMENTS, TRENDS, AND
FUTURE DEVELOPMENT
Dorothy A. Jones and Jane Flanagan 477(18)
The cost efficiency and therapeutic
effectiveness of APN's (including the
clinical nurse specialist, nurse
midwife, nurse anesthetist, and nurse
practitioner) has been discussed in
many forums. This chapter provides a
comprehensive synthesis of the
contributions made by the APN to
improve practice and enhance
evidence-based outcomes. Also included
is an overview of the work environments
employing the APN, and a review of
salaries and potential directions for
expanding practice and using nursing
knowledge to effect outcomes across
populations and settings.
23 MEASURING ADVANCED PRACTICE NURSE
PERFORMANCE: OUTCOME INDICATORS, MODELS OF
EVALUATION, AND THE ISSUE OF VALUE
Shirley Girouard 495(39)
APN's can no longer assume that it is
adequate to be accountable to their
patients alone. Consumers, purchasers
of care, employers, and policy makers
are demanding evidence that APN
practice makes a difference in outcomes
and is cost effective. This chapter
will address reasons for and approaches
to measuring performance and
establishing the value of advanced
practice nursing.
24 THE ADVANCED PRACTICE NURSE AS EMPLOYEE OR
INDEPENDENT CONTRACTOR: IT MAKES A DIFFERENCE
Kammie Monarch 534(19)
Employee status confers very definite
legal rights and responsibilities. The
choice whether to be an employee versus
an independent contractor should be
informed by knowledge of the
differences. The author explores these
differences as well as the details of
executing written practice agreements
governing the working relationship
between the APN and other parties. This
is a relatively new aspect of practice
and it is important for the APN to
understand the basic, foundational
issues that need to be addressed in
these written agreements. The author
has identified a number of those
issues, and also addresses the relevant
case law.
25 PROMOTING ADVANCED PRACTICE NURSES TO THE
PUBLIC
Donna A. Gaffney 553(24)
How do we sell the APN to the public?
Most of our market has been the poor
and disenfranchised. For success and
security, APNs need to sell their
services to the critical mass that is
Middle America.
26 STARTING A PRACTICE AND PRACTICE MANAGEMENT
Judith Pollachek 577(35)
Independent practice allows the APN to
maximize patient care, spend time on
needed patient education, and encourage
patient participation in determining
their own health care regimen. But an
entrepreneurial spirit, a fine-tuned
knowledge base and clinical skill, and
the desire to provide quality health
care aren't enough. Learn how to
negotiate the winding road of rules and
regulations, strategize for its
pitfalls and detours, and ultimately
know the rewards of delivering health
care your way.
27 THE LAW, THE COURTS, AND THE ADVANCED
PRACTICE NURSE
Virginia Trotter Betts, David Keepnews, 612(27)
and Kammie Monarch
A summary of the legal principles
shaping and affecting advanced practice
nursing. The authors present a
discussion of selected legal issues and
court cases involving APNs.
28 ETHICS AND THE ADVANCED PRACTICE NURSE
Gladys L. Husted and James H. Husted 639(26)
The authors will consider the ethical
decision-making competencies of the
APN, and the barriers that exist to
ethical practice. This will be
accomplished through a context-based
model that concentrates on the
professional agreement that exists
between nurse and patient. A
context-based model actualizes the
concept of treating persons as
individuals and therefore selecting
interactions based on that unique
patient's needs and circumstances. Each
patient entering the health care system
hopes to derive some benefit. He hopes
to regain his competence to perform his
normal functions and to live his life
as he chooses. At the very least, he
expects to come out better able to live
than when he went into that health care
system. Emphasis will be given to the
rights of nurse and patient deriving
from their implicit commitments and
expectations. Case examples will be
used in the presentation.
INDEX 665